Effect Of Ulinastatin Combined With Dexmedetomidine On Postoperative Cognitive Function In Elderly Patients With Colorectal Cancer

Objective:To investigate the effect of ulinastatin combined with dexmedetomidine on postoperative cognitive function of elderly patients with colorectal cancer.Methods:1.128 elderly patients who underwent laparoscopic radical resection of colorectal cancer in Shanxi Provincial People’s Hospital from January 2019 to December 2020 were randomly divided into four groups: control group,ulinastatin group(U group),dexmedetomidine group(Dex group)and ulinastatin combined with dexmedetomidine group(U+Dex group),with 32 cases in each group;2.10,000 U/kg ulinastatin was dissolved in 500 ml normal saline by intravenous drip10 min before induction in U and U+Dex groups,which started 10 min before induction of anesthesia in Dex and U+Dex groups,and dexmedetomidine was pumped at a loading dose of 0.5 μ g/(kg h)for 10 min,and then continued at 0.3 μ g/until 30 min before operation;3.The content of S100β protein was measured by ELISA in patients’ radial artery blood before operation and 10 min after extubation.The cognitive function of patients was evaluated by MMSE before operation and 1 day,3 days and 7 days after operation,and the correlation between 10 min S100β protein 10 m after extubation and MMSE score after operation was studied;4.The recovery time of spontaneous breathing,the time of opening eyes and the time of extubation were recorded;5.Record the incidence of postoperative adverse reactions such as cough,restlessness,hypertension,nausea and vomiting in each group;6.The basic characteristics(sex,age,height,weight and complications)and intraoperative indicators(anesthesia time and operation time)of the four groups were compared.Results:1.There was no significant difference in S100 β protein between the groups before operation(P > 0.05).Ten minutes after extubation,the content of S100 β protein in arterial blood of ulinastatin combined with dexmedetomidine group was the lowest,followed by drug alone group and the highest in control group(P < 0.05).The MMSE score of ulinastatin combined with dexmedetomidine was the highest on the 1st and 3rd postoperative day,followed by the single drug group and the lowest in the control group(P < 0.05),which also proved that the content of S100β protein in arterial blood 10 min after extubation was correlated with the MMSE score on the 1st and 3rd postoperative day.2.There was no significant difference in spontaneous breathing recovery time,eye opening time and extubation time between the groups.3.The incidence of postoperative adverse reactions such as cough,restlessness,hypertension,nausea and vomiting was the lowest in the combined medication group,followed by the single medication group and the highest in the control group(P < 0.05).4.There was no significant difference in basic characteristics and intraoperative indicators among the four groups(P > 0.05).Conclusion:Ulinastatin or dexmedetomidine alone can reduce the incidence of postoperative adverse reactions,improve the MMSE score of postoperative cognitive function and reduce the content of S100β protein in arterial blood in elderly colorectal cancer patients to a certain extent,but the combination of the two can achieve more satisfactory results.In addition,it is also proved that the content of S100β protein in arterial blood 10 min after extubation is correlated with the MMSE scores of 1 day and 3 days after operation.